D.3 Organizational Conflict of Interest.pdf
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- Attached to
- Q531--HEMODIALYSIS FOLLOW ON - Columbia
- Solicitation number
- 36C25525Q0252
About this file
This document is a Contractor Conflict of Interest Certification Statement for a VA hemodialysis services solicitation at the Harry S. Truman Memorial Veterans' Hospital. The solicitation (Number 36C25525Q0252) requires potential contractors to disclose any past, present, or planned interests that could create an organizational conflict of interest. Contractors must either certify no conflicts exist or provide a detailed statement explaining any potential conflicts, including information about consultants and subcontractors. The document outlines that failure to disclose conflicts may result in contract termination, and the Contracting Officer has the authority to disqualify a contractor or request a waiver if conflicts cannot be mitigated.
The associated federal contract opportunity involves on-site hemodialysis services at the VA Medical Center in Columbia, Missouri. The facility has a dialysis suite with 3 beds/bays and provides treatments both in the suite and on hospital units. Historical treatment volumes include 86 one-to-one hemodialysis treatments, 221 two-to-one hemodialysis treatments, 41 peritoneal dialysis treatments, and 40 Continuous Renal Replacement Therapy (CRRT) treatments per month. A site visit for potential vendors is scheduled for August 1, 2025, from 10:00 AM to 12:00 PM EST at 800 Hospital Drive, Columbia, MO.
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D.3 ORGANIZATIONAL CONFLICTS OF INTEREST 36C25525Q0252
ORGANIZATIONAL CONFLICTS OF INTEREST
852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)
All healthcare contracts require response to the following provision as prescribed in
VAAR 809.507-1(b). Please use the form in APPENDIX A to provide response.
ORGANIZATIONAL CONFLICTS OF INTEREST
(a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the Offeror’s performance of work under the contract may provide the Contractor with an unfair competitive advantage. The term “organizational conflict of interest” means that because of other activities or relationships with other persons, a person is unable to render impartial assistance or advice to the Government, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or the person has an unfair competitive advantage.
(b) The Offeror shall provide a statement with its offer which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The Offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The Offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.
(c) Based on this information and any other information solicited or obtained by the
Contracting Officer, the Contracting Officer may determine that an organizational conflict of interest exists which would warrant disqualifying the Contractor for award of the contract unless the organizational conflict of interest can be mitigated to the Contracting Officer’s satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the Contracting Officer finds that it is in the best interest of the United States to award the contract, the Contracting Officer shall request a waiver in accordance with FAR
9.503.
(d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.
D.3 ORGANIZATIONAL CONFLICTS OF INTEREST 36C25525Q0252
Organizational Conflict of Interest
[CONTRACTOR NAME]
[ADDRESS]
SOLICITATION # 36C25525Q0252
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] ____[CONTRACTOR NAME]________________ represents that no individuals involved with the solicitation [Solicitation # 36C25525Q0252 and On-site Hemodilaysis Services] have no present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the Harry S. Truman Memorial Veterans' Hospital Veterans Administration under the referenced solicitation.
None of the employees listed in the solicitation have a past interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the Harry S. Truman Memorial Veterans' Hospital Veterans Administration under the referenced solicitation.
OR
[ ] Statement attached describing, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.
NAME OF CERTIFYING OFFICIAL
TITLE
SIGNATURE DATE
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